Objective To determine the clinical features of Klebsiella pneumoniae pneumonia and antimicrobial resistance of Klebsiella pneumoniae, providing the basis for rational use of antibiotics. Methods Eighty-six strains of Klebsiella pneumoniae were isolated from the sputum specimen which collected from the inpatients in our hospital from Dec 2008 to Dec 2010,which were identified with Bio Merieum Vitek 2. A total of 86 children were enrolled in the study, which were divided into hospital infection/colonization group (n = 68) and community infection group (n = 18). Clinical information were recorded. Extended spectum β-lactamase (ESBLs) and antibiotic susceptibility of Klebsiella pneumoniae were determined. Results Klebsiella pneumoniae pneumonia in children mainly occured in infants, especially in infants with basic diseases.Clinical manifestations of Klebsiella pneumoniae pneumonia had no much difference from common pneumonia. The detection rate of ESBLs was high(76. 7%). ESBLs were found in 64 strains of the hospital infection/colonization group (94. 1% ,64/68) ,while in 2 strains of the community infection group (11. 1% ,2/18).There was a significant difference between the two groups (P ＜0. 01). The drug resistance of hospital infection/colonization group was significantly higher than that of community infection group. The strains of hospital infection/colonization group were sensitive with cefotan, piperacillin/tazobactam, carberpenem, amikacin and ciprofioxacin only, while were highly resistant to penicillins, cephalosporins and monoamine antibiotics.The average hospital stay of the hospital infection/colonization group was (15.0 ± 7. 1) d, while the other was (8. 2 ± 3. 8) d. There was a very significant difference between the two groups in average length of stay (P＜0.01). Conclusion Klebsieila pneumoniae pneumonia in children mainly occurs in infants with basic diseases. The symptoms are untypical. Klebsiella pneurmoniae multi-drug resistance is a serious problem,which must be paid attention to. We should make a difference between the two groups when antibiotics were prescribed.

Objective To understand the etiology and clinical features of childhood bronchiectasis in China. Methods Data of 182 children diagnosed with bronchiectasis admitted in Children's Hospital of Chongqing Medical University from 1991 to May, 2015, and more than 20 cases in the Chinese literatures since 1990 were reviewed. Results The top three causes of bronchiectasis in 182 children (114 boys, 68 girls, median age:118 months) in Chongqing were post-infection, primary immunodeficiency and foreign body, with frequency of 29.7%, 7.7%, and 7.1%, respectively. Chronic wet cough was the most frequent feature. Diagnosis of bronchiectasis usually need to combine with chest CT findings, which showed that the lesions were at left lower lobe, right middle lobe and right lower lobe. The choice of antibiotics was based on bacterial cultures of respiratory secretions, and Streptococcus pneumoniae was the most frequently isolated bacteria in Chongqing. The most common three causes of bronchiectasis in children according to data of 572 cases ( 347 boys, 225 girls) in 7 cities of China including Chongqing were the same with that of Chongqing, 45.5%, 7.3%, and 5.6%, respectively. Conclusion Early diagnosis, identification of etiology and comprehensive management of bronchiectasis in children are benefitial for prognosis.

Primary ciliary dyskinesia (PCD) is an autosomal recessive or x-linked disorder of cilia structure and (or) function, with a morbidity of 1:10 000–1:50 000 from foreign reports, while epidemic data of PCD in China is not available yet. PCD is due to cilia biallelic gene mutations leading to impaired tissue structure and organ function. Clinical phenotypes include chronic infections of the respiratory tract, fertility problems, disorders of organ laterality, etc, and the percent age of Kartagener syndrome is about 50%. The frequently used diagnostic methods are nasal NO examination, high-speed video microscopy, electron microscopy, genetic tests, chest high-resolution computed tomography and spirometry at present. Each method has its highlights and disadvantages, meanwhile, effective diagnostic algorithm and therapeutic protocols are needed for further research.

BACKGROUND:How to control functional activity of donor liver after cardiac death and maintain the optimal function of grafts are the key issues in organ transplantation study.
OBJECTIVE:To preliminarily explore the effect of warm ischemia injury on the morphology and function of rat donor liver after cardiac death.
METHODS:Cardiac death model was established in Sprague-Dawley rats and the successful models were divided into six groups:control group (warm ischemia for 0 minute), warm ischemia 10 group (warm ischemia for 10 minutes), warm ischemia 20 group (warm ischemia for 20 minutes), warm ischemia 30 group (warm ischemia for 30 minutes), warm ischemia 40 group (warm ischemia for 40 minutes) and warm ischemia 50 group (warm ischemia for 50 minutes). The rat liver specimens in each group were cut into ultrathin sections. The structure of liver cells was observed and photographed by electron microscopy. Flameng score was applied to analyze the degree of mitochondrial damage. Liver mitochondria were extracted and then spectrophotometry was used to assess the viability of cytochrome C oxidase.
RESULTS AND CONCLUSION:Under electron microscopy, there were no significant changes in liver cells within 30 minutes of warm ischemia, nuclear membrane was intact, mitochondria mildly swel ed, no mitochondrial crista ruptured, and Flameng score was<2 points. With the extension of warm ischemia time, the cells became swel ing, nuclear chromatin condensated, apoptotic body was clearly visible, mitochondrial matrix coagulated, mitochondria exhibited vacuolation, and Flameng score was 3-4 points. The viability of cytochrome C oxidase showed no significant difference within 30 minutes of warm ischemia, but began to significantly decrease at 40 and 50 minutes. The mitochondrial structure and function after liver injury is not obviously affected by 30 minutes of warm ischemia, and significant changes appear after 40 minutes.

OBJECTIVE:To observe the efficacy and safety of domestic cefepime in the treatment of patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD) complicated with respiratory failure. METHODS:A total of ninety-six patients with AECOPD complicated with respiratory failure were randomly assigned to receive cefepime 2.0 g bid iv gtt (Group A,n=48) or cefoperazone/sulbactam (Group B,n=48) at a dose of 2.0 g bid iv gtt for 7～14 day. RESULTS:The effective rate was 82% for Group A versus 62% for Group B(P0.05). CONCLUSION:The efficacy of cefepime is higher than that of cefoperazone/sulbactam in the treatment of patients with AECOPD complicated with respiratory failure,but both had good safety.

OBJECTIVE:To evaluate the cough-relieving and sputum-eliminating efficacy and safety of Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution.METHODS:By a randomized control study,a total of 60 patients characterized by nonproductive cough andlittle sputum were randomly assigned to receive Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution(Trial Group)or Ambroxol Hydrochloride Oral Solution(Control Group)l0 mL tid for 5～7 d.RESULTS:Both groups had a significant improvement in symptoms including cough and expectoration after treatment(P0.05).CONCLUSION:Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution is more effective in relieving cough than Ambroxol Oral Solution,and it has certain effect in eliminating phlegm.In addition,it is safe and has little adverse reaction.

Objective To compare the effect of diversification rehabilitation team mode on function in patients with cerebral infarction. Methods Sixty-six patients with cerebral infarction were divided into diversification rehabilitation team mode group (diversification group) and routine rehabilitation mode (routine group) according to the rehabililation method with 33 cases each. All patients of 2 groups were treated for 2 weeks. Evaluations were made before and after treatment. The simplified Fugl-Meyer motor function rating scale was used to evaluate motor function, modified Barthel index was used to evaluate activities of daily living, and MOS 36-item short form health survey was used to evaluate quality of life;and 0-100 digital simulation assessment was used to evaluate patient satisfaction after treatment. Results The simplified Fugl-Meyer motor function rating scale score, modified Barthel index score, MOS 36-item short form health survey score and patient satisfaction rate after treatment in diversification group were significantly better than those in routine group: (76 ± 4) scores vs. (63 ± 3) scores, (65 ± 3) scores vs. (52 ± 4 ) scores, (57 ± 7) scores vs. (44 ± 6) scores, (92 ± 5) scores vs. (77 ± 3) scores, and there were statistical differences (P<0.05). Conclusions Both kinds of rehabilitation model can promote functional recovery in patients with cerebral infarction, but diversification rehabilitation team model is better than conventional model.

ObjectiveTo explore the effect of statin in reduction of my ocardial injury in patients undergoing percutaneous coronary intervention(PCI).MethodsTotal of 185 patients undergoing PCI were included,140 patients were received atorvastatin before PCI,while 145 were not given statins at the time of PCI.Creatine kinase-MB and troponin Ⅰ were measured at baseline and at 8 and 24 hours after the procedure.ResultsPost procedurul peak levels of troponin Ⅰ and creatine kinase-MB were(0.12 ±0.26) μg/L and(2.61 ± 3.07) μg/L in the observation group,which were significantly lower than(0.51 ± 1.14) μg/L and( 6.85 ± 14.38 ) μg/L in the control group( t =3.951,3.414,P ＜ 0.05).ConclusionPretreatment with atorvastatin for 7 days could significantly reduces procedural myocardial injury in elective PCI.

OBJECTIVE:To observe clinical efficacy and safety of levofloxacin and azithromycin in the treatment of community acquired mycoplasma pneumonia (CAMP).METHODS:A total of 108 patients with CAMP were randomly divided into group A and group B (n=54).Group A received intravenous administration of levofloxacin (0.6 g,qd) and group B intravenous administration of azithromycinin (0.5 g,qd) for 7 days.The clinical efficacy and ADR of 2 groups were observed.RESULTS:The total effective rates of group A and group B were 83% and 56%,there was significant difference between 2 groups (P0.05).CONCLUSION:The clinical efficacy of levofloxacin in the treatment for CAMP is better than that of azithromycin.Levofloxacin and azithromycin have good safety.

AIM: To establish the method for determining tetrahydropalmatine、rhynchophylline and isorhynchophylline in AnshenYangxue Oral Liquid(Ramulus uncariae cum uncis, stephania kwangsiansis,Radix polygoni multiflori praeparata cum succo glycinus sotae,Caulis Polygoni multiflori and Pine needle). METHODS: Tetrahydropalmatine、rhynchophylline and isorhynchophylline were determined by HPLC.Chromatographic condition was composed of Kromasil C_18 column,a mixture of methanol and water(55∶45) as mobile phase with 0.01 mol/L triehthylamine,adjusted with acetic acid to pH of 7.5,UV detection wavelength of rhynchophylline and isorhynchophylline was set at 254 nm,UV detection wavelength of tetrahydropalmatine was set at 281 nm. RESULTS: The averagere recoveries of tetrahydropalmatine、rhynchophylline and isorhynchophylline were 98.47%、99.04%and 98.75% respectively;RSD were 0.95%、2.6%and 1.6%,respectively. CONCLUSION: This method is simple,sensitive,accurate,and can be used for determining tetrahydropalmatine、rhynchophylline and isorhynchophylline in Anshen Yangxue Oral Liquid.